The use of statins (a class of drugs that effectively lowers blood cholesterol by inhibiting its production) is widespread, but there is growing concern that cholesterol lowering may not target the whole problem. If a patient has other risk factors (for example high blood pressure or high triglycerides), the typical course of action is to prescribe additional drugs, but this poses an increased cost and greater likelihood of side effects with multiple drug use. Therefore, it makes sense to consider how statins could be enhanced, or perhaps avoided altogether, by a therapeutic diet. Surprisingly, few studies have examined how diet in combination with statin treatment affects a spectrum of risk markers.

My lab group recently published results of an experiment where we examined the effect of a very low carbohydrate diet on measures of cholesterol and other risk factors related to heart disease in a group of men who had been successfully using statins to lower their cholesterol. After 6 weeks the low carbohydrate diet resulted in significant improvements in a number of risk markers while maintaining previously reduced levels of LDL cholesterol. For example, the quality of LDL improved as measured by an increase in LDL particle size (larger LDL particles are not as harmful as smaller ones). Additionally, there were significant improvements in plasma triglycerides (reduced by 36%), insulin sensitivity (increased by 25%), systolic blood pressure (-5%) and diastolic blood pressure (-6%), and blood flow in the forearm. There were also significant reductions in some inflammatory markers.

These results emphasize that statins alone do not target many of the common risk factors present in the population, but when used in combination with a low carbohydrate diet, there is broad spectrum improvement that extends beyond lowering of plasma cholesterol.

Jeff S. Volek is a professor in The Human Performance Laboratory at The University of Connecticut, Storrs, CT. He is an R.D. and has a Ph.D. in Kinesiology (Pennysylvania State University). He serves on the editorial boards of Nutrition and Metabolism and the Journal of Strength and Conditioning Research. He has published over 250 scientific articles and chapters.

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